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Washington rates for HCPCS 33987

Arterial exposure with creation of graft conduit (eg, chimney graft) to facilitate arterial perfusion for ECMO/ECLS (List separately in addition to code for primary procedure)

Facilitymedian $490 · 10th–90th $331–$20,8930%20%10th90th$490Professionalmedian $275 · 10th–90th $200–$5250%10%20%10th90th$275$20.0$100.0$500.0$2.0K$10.0K

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$371.54 / $524.81 / $20,892.96
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$199.53 / $257.04 / $501.19
Asuris Northwest Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$281.84 / $407.38 / $512.86
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$269.15 / $407.38 / $588.84
Kaiser Permanente
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$257.04 / $426.58 / $562.34
Kaiser Permanente
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$257.04 / $426.58 / $562.34
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$32.36 / $32.36 / $33.11
Pacific Source
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$331.13 / $380.19 / $407.38
Premera BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$275.42 / $275.42 / $275.42
Premera BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$275.42 / $416.87 / $575.44
Regence BlueShield
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$281.84 / $398.11 / $512.86
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$194.98 / $2,454.71 / $5,754.40
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$218.78 / $323.59 / $524.81
Wellpoint
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$213.80 / $251.19 / $371.54